Hematocolpos as a result of Delayed Rx of Acute Straddle Inj
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Case Presentation
A 14-year-old girl visited our Emergency Department with vaginal bleeding. She fell down at home and suffered a straddle injury to the perineal area. She had no underlying disease, and menarche had occurred two months ago.

Her parents stated that there was about 400?cc of blood loss from the laceration and they were not cooperative with physical examination of her genital area because of pain and resistance to gynecological examination in emergency department. Her vital signs on arrival were as follows: blood pressure, 139/64?mmHg; heart rate, 109/min; respiratory rate, 20/min; temperature, 36.5°C; and the hemoglobin/hematocrit was 12.1/35.4?mg/dL. The patient and her parents did not give their consent for an invasive procedure; hence emergency team decided to perform expectation therapy under compression procedure.

After two hours, her abdominal pain was aggravated throughout the whole abdomen. Blood pressure was 90/60?mmHg, pulse rate was 120/min, respiratory rate was 20/min, and body temperature was 37.2°C. Emergency team decided to perform pelvic computed tomography (CT) scans for identifying internal organ damage after injury 2 hours later. The pelvic CT showed hematocolpos with active vaginal bleeding. Her vagina was filled with high attenuation fluid, implying blood, and extravasation of the contrast material from 4-5 o'clock position of the vagina was observed. It suggested that active bleeding was ongoing.....